法医学杂志

法医学杂志 ›› 2018, Vol. 34 ›› Issue (4): 359-362.DOI: 10.12116/j.issn.1004-5619.2018.04.003

• 论著 • 上一篇    下一篇

L1～2椎体压缩性骨折后原有高度的评估

卓佩佩1，2，汪茂文2，俞晓英2，万  雷2，檀思蕾2，3，陈捷敏2，夏文涛1，2   

  1. 1. 温州医科大学法医学系，浙江 温州 325035； 2. 司法鉴定科学研究院 上海市法医学重点实验室 上海市司法鉴定专业技术服务平台，上海 200063； 3. 苏州大学医学部法医学系，江苏 苏州 215006
  • 发布日期:2018-08-25 出版日期:2018-08-28
  • 通讯作者: 夏文涛，男，研究员，主要从事法医临床学研究和鉴定；E-mail：xiawt@ssfjd.cn
  • 作者简介:卓佩佩（1994—），女，硕士研究生，主要从事法医临床学研究；E-mail：peipeirixi@163.com
  • 基金资助:
    “十三五”国家重点研发计划资助项目（2016YFC0800701）；上海市法医学重点实验室资助项目（17DZ2273200）；上海市司法鉴定专业技术服务平台资助项目（16DZ2290900）

Assessment of the Original Height of L1-2 after Vertebral Compression Fracture

ZHUO Pei-pei1,2, WANG Mao-wen2, YU Xiao-ying2, WAN Lei2, TAN Si-lei2,3, CHEN Jie-min2, XIA Wen-tao1,2   

  1. 1. Department of Forensic Medicine, Wenzhou Medical University, Wenzhou 325035, China; 2. Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China; 3. Department of Forensic Medicine, Medical College of Soochow University, Suzhou 215006, China
  • Online:2018-08-25 Published:2018-08-28

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摘要： 目的 探索L1～2椎体压缩性骨折后原有高度的评估方法及其在法医临床学鉴定实践中的应用价值。 方法 收集154例正常人群的胸腰椎侧位X线片，140例作为实验组，14例作为验证组。测量每例X线片中T12～L3椎体的前缘高度（Ha）、后缘高度（Hp）。实验组中，对HaL1与HaT12、HpT12、HpL1、HaL2、HpL2进行相关性分析，拟合回归方程；对HaL2与HaL1、HpL1、HpL2、HaL3、HpL3进行相关性分析，拟合回归方程。并通过验证组验证HaL1、HaL2预测值与实际测量值之间的差异。 结果 实验组HaL1（y1）与HaT12（x1）、HaL2（x2）相关性较好，多元线性回归方程为：y1=2.545+0.423 x1+0.486 x2（决定系数R2=0.712，P＜0.05；F=169.206，P＜0.05）。验证组HaL1预测值与实际测量值之间的差异无统计学意义（P＞0.05）。实验组HaL2（y2）与HaL1（x3）、HaL3（x4）相关性较好，多元线性回归方程为：y2=4.354+0.530 x3+0.349 x4（决定系数R2=0.689，P＜0.05；F=151.575，P＜0.05）。验证组HaL2预测值与实际测量值之间的差异无统计学意义（P＞0.05）。 结论 当L1或L2单椎体发生压缩性骨折时，根据压缩椎体上、下相邻椎体的前缘高度来评估压缩椎体的原有高度较为适宜。

关键词: 法医学, 脊柱, 胸椎, 腰椎, 骨折, 压缩性, 线性回归

Abstract: Objective To explore the assessment method of original height of L1-2 after vertebral compression fracture and its application value in forensic clinical practice. Methods A total of 154 normal thoracic and lumbar X-ray films were collected, and 140 cases were used as experimental group while 14 cases as validation group. The heights of anterior （Ha） and posterior （Hp） vertebral body of T12-L3 vertebrae in each X-ray image were measured. In the experimental group, the correlation analysis between HaL1 and HaT12, HpT12, HpL1, HaL2 and HpL2 was carried out, and regression equation was established via fitting. The correlation analysis between HaL2 and HaL1, HpL1, HpL2, HaL3, HpL3 was performed, and the regression equation was also established via fitting. The difference between the predicted and measured values of HaL1 and HaL2 in validation group was compared. Results In the 140 normal subjects, HaL1 （y1） was well correlated with HaT12 （x1） and HaL2 （x2）, and the multiple linear regression equation was y1=2.545+0.423 x1+0.486 x2 （determining coefficient R2=0.712, P<0.05; F=169.206, P<0.05）. There was no significant difference between the predicted and actual measured values of HaL1 in the validation group （P>0.05）. HaL2 （y2） was well correlated with HaL1 （x3） and HaL3 （x4）, and the multiple linear regression equation was y2=4.354+0.530 x3+0.349 x4 （determining coefficient R2=0.689, P<0.05; F=151.575, P<0.05）. There was no significant difference between the predicted and actual measured values of HaL2 in the validation group （P>0.05）. Conclusion It is more appropriate to evaluate the original height of L1 or L2 single vertebrae by comparing with the height of the anterior edge of the upper and lower adjacent vertebral bodies.

Key words: forensic medicine, spine, thoracic vertebrae, lumbar vertebrae, fractures, compressive, linear regression